Headache is a common condition that can occur in anyone. Most headaches are not caused by serious conditions. However, frequent or severe headaches need to be diagnosed and treated by specialists because they may be a warning sign of a serious disease.
There are 4 types of headaches as follows
- Tension-type headache
The most common tension-type headache usually occurs in people who are stressed, tired, or overworked. The pain is typically described as a tight or pressing sensation on both sides of the head and neck. The pain is usually mild to moderate in intensity and may be accompanied by muscle pain in the head, neck, and shoulders. - Migraine headache
This is a common headache disorder that is often misdiagnosed. Migraine headaches are frequently found in working-age women. The pain is usually moderate to severe and can worsen with external triggers such as light, sound, or smell. Some patients may experience nausea and vomiting. Most migraines last at least 4 hours, and in some cases, the pain can last up to 3 days. - Cluster headache
This type of headache is more common in men than women. The pain is severe enough to cause restlessness. It usually occurs suddenly and lasts from about 15 minutes to 3 hours. The pain is typically located around the eye or temple and is usually one-sided. Patients may also have parasympathetic nervous system symptoms such as red eyes, tearing, runny nose, and sweating on the side of the face where the headache occurs. - Chronic daily headache
Patients usually experience chronic headaches more than 15 days per month for at least 3 months. The headache may be tension-type or migraine, but the symptoms are more persistent. Some patients in this group may have medication overuse headache caused by misdiagnosis, self-medication, or frequent use of painkillers, which worsens the chronic headache. Other causes may include sinusitis, stroke, subarachnoid hemorrhage, or cancer. Diagnosis requires detailed history taking, physical examination, and additional tests such as MRI to rule out dangerous conditions.
What types of headaches require urgent medical attention?
- Sudden severe headache
- Headache accompanied by fever and stiff neck
- Headache with abnormal neurological symptoms such as weakness in limbs, confusion, or personality changes
- Headache in patients with cancer, HIV infection, or immunodeficiency
- Headache that progressively worsens and does not respond to treatment
However, headaches are common symptoms that require detailed history taking, thorough physical examination, and additional diagnostic tests in some patients to achieve an accurate diagnosis and effective treatment.
Dr. Lalitpan Sudprasert
Neurology and Brain Specialist
Internal Medicine Center, Phyathai Nawamin Hospital
